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Piriformis syndrome is a neuromuscular condition where the piriformis muscle – one of the deep gluteal muscles – presses on and compresses the sciatic nerve causing pain, tingling and numbness in the buttock area and down the path of sciatic nerve to the thigh and leg.
Sciatic nerve runs UNDER the piriformis muscle and may be irritated when the muscle is too tight or shortened due to spasms. Piriformis syndrome is to be differentiated from sciatica which shows similar symptoms but has different causes.
Diagnosis is commonly done by EXCLUSION of sciatica. Because sciatica usually associates with compression of sciatic nerve roots by a herniated disc, sciatic symptoms in the ABSENCE of spinal disc herniation are indicative of piriformis syndrome.
Causes and risk factors of piriformis syndrome include:
– Anatomical abnormality of the nerve-muscle relation. Some people are more likely to get piriformis syndrome than others.
– Tightness or spasm of the piriformis muscle due to overuse injury. This commonly happens in sport activities that put pressure on the piriformis muscle such as bicycling, running without proper stretching, or any activity that involves repeated movements of the legs performed in sitting position.
Treatment options include:
– Stretching exercises, massage, avoidance of causative activities.
– Anti-inflammatory drugs, muscle relaxants for relief of symptoms.
– Physical therapy that strengthens the gluteus maximus, gluteus medius, and biceps femoris is usually recommended to reduce strain on the piriformis muscle.